Professor Boyle: 'We need a way of making commissioning simpler' (Photograph: CRY)

Professor Roger Boyle, England's national director for heart disease and stroke, said there should be contracts itemising what needs to be in place to maintain and improve the quality of services.

'We need to find a way of making commissioning simpler,' he said. 'You don't want to have to rewrite the process over and over again for routine, procedural type processes.'

Professor Boyle said there needed to be 'a facilitative process in place that allows standard contracts to be used for many common disease areas so that we do not have to reinvent the wheel'.

Quality standards prepared by NICE would help in this regard, he said.

A NICE spokeswoman said that the institute's quality standards would set a quality benchmark that GPs could use to help deliver high-quality care locally.

RCGP chairwoman Dr Clare Gerada said the college's centre for commissioning had been set up to ensure that GPs have the skills to commission effectively.

'The centre has already rolled out a programme of commissioning workshops across the country, and is preparing to host a summit for patients, patient groups, third sector organisations and GPs,' she said.

London GP Dr Sebastian Kalwij, GP champion for the national chlamydia screening programme for England, said that a great deal of guidance and information was available to help commissioners.

But awareness of these needed to be raised so that GPs knew what was already available, he said.

Dermatology GPSI Dr Stephen Hayes said that, as well as using guidelines from NICE and other bodies, it was crucial that GPs worked with consultants to design services. 'Primary and secondary care need to engage with each other,' he said. 'One thing I would deplore would be for commissioners to set up services without consulting with local dermatologists.'